Azithromycin 500mg Tablets (Traveller's Diarrhoea Pack)

Azithromycin is a first-line treatment for traveller’s diarrhoea caused by common bacterial infections in most countries. It is an antibiotic that kills diarrhoea-causing bacteria and reduces the symptoms and duration of traveller’s diarrhoea, especially when taken with loperamide. The dose of Azithromycin is one tablet daily for three days. Begin taking Azithromycin as soon as you develop diarrhoea, not before. It cannot be used as a preventative measure.

You can also take the anti-sickness tablet, Avomine, to minimize fluid loss and discomfort.

Azithromycin is the preferred antibiotic for treating travellers' diarrhoea in South Asia (India, Pakistan) or SE Asia (Thailand, Laos, etc.). In other parts of the world, the antibiotic ciprofloxacin is preferred.

Traveller's Diarrhoea is a common condition effecting 20-50% of international travellers. It usually occurs during the first two weeks of travel to a foreign country, especially in the developing world where it can effect up to 60% of travellers.

Symptoms of Traveller's Diarrhoea include passing three or more unformed stools within 24 hours, often accompanied by nausea, stomach pain, bloating, vomiting and/or fever.

Traveller's Diarrhoea can be contracted when the body is exposed to unfamiliar bacteria. Bacterial infections normally account for around 85% of cases. For the local population, these bacteria are often harmless but for a foreign traveller they may result in infection. Viruses and parasites may also account for a minority of traveller’s diarrhoea.

The organisms that cause traveller's diarrhoea include bacteria such as E. coli and Salmonella, parasites such as Giardia and viruses like norovirus. These organisms can be contracted through contaminated food and beverages as well as contact with dirty hands and plates.

Avoiding contaminated foods is the most effective way to prevent Traveller's Diarrhoea. Basic precautions include:

• Drink only safe water and beverages that have been boiled, bottled or distilled. Avoid tap water and hot drinks which have not been boiled.
• Avoid ice cubes as they may be made with contaminated tap water.
• Avoid ice-cream and other frozen desserts as many developing countries experience frequent power cuts which means these products can defrost and refreeze at unsafe temperatures.
• Avoid raw fruit and vegetables that you have not peeled.
• Avoid salads as they may have been washed with contaminated water.
• Wash your hands before eating.

Standby treatment is recommended for the following travellers:

• Travellers who often experience diarrhoea while travelling abroad
• Travellers with bowel conditions such as IBS.
• Travellers to destinations far from medical help.
• Travellers who have conditions which may be aggravated by severe dehydration/diarrohea.

• Record your other symptoms. Diarrhoea can be a symptom of other travel illnesses such as malaria or hepatitis. It is important to see a doctor if you do not improve within 3 days or have other severe symptoms such as headache or fever.
• Be cautious with water, ice, fruit, salads and seafood. These are usually the main culprits with traveller’s diarrhoea. Try to stick to bottled water and avoid fruits that cannot be peeled. Avoid drinks with ice and salads that may have been washed in water that is not fit for drinking.

Non-Prescription Alternatives

Imodium is one of the UK's most well known diarrhoea treatment, and the original Imodium Capsules have provided a tried and trusted remedy for almost 40 years. The formula provides fast and effective relief from the symptoms of diarrhoea, while gently helping to restore your body's natural rhythm in just a single dose.

Dioralyte does not cure or treat diarrhoea. It will help to replace any fluids and electrolytes lost through diarrhoea; however it will have no curative effect.

OTC (over the counter medication) alternative for Travellers' Diarrhoea

In some more simple cases travellers' diarrhoea can be treated with over-the-counter medicines. These medicines include Loperamide (Imodium) and re-hydration sachets (Dioralyte). Using these products together will help ease the symptoms, this will help as your body is trying to fight off the infection. You must also ensure you remain hydrated so take on as much fluids as possible during this time, as dehydration is the most dangerous consequence of Travellers' diarrhoea.

not take Azithromycin tablets if:

• you have liver, kidney, or heart problems.
• You have low levels of potassium or magnesium.
• you develop symptoms of another infection.
• you take any derivatives of ergot such as ergotamine (for migraines). Read the section below about taking Azithromycin with other medications.
• you have muscle weakness, myasthenia gravis.
• you have neurological or psychiatric problems.

Consult your doctor or pharmacist if you are taking any of the following medications:

Antacids - Azithromycin should be taken at least 1 hour before or 2 hours after the antacid

Ergotamine - (for migraine treatment) should not be taken with Azithromycin as the combination may cause serious side effects such as numbness or tingling in the limbs, headaches, muscle cramps, convulsions, chest or abdominal pain.

Cholesterol-lowering medications, statins.

Warfarin or similar medicines – Blood thinners. Azithromycin can further thin the blood.

Cisapride - For stomach problems. This medication should not be taken with Azithromycin as severe heart problems may result.

Terfenadine - For hay fever. When taken with Azithromycin, severe heart problems may develop.

Zidovudine or Nelfinavir - For HIV treatment. Taking nelfinavir with Azithromycin may make you susceptible to more of the side effects listed in this leaflet.

Rifabutin - For tuberculosis treatment.

Quinidine – For treatment of heart rhythm problems.

Cyclosporin – For preventing organ-rejection. Your doctor will regularly check your blood levels of cyclosporin and may change your dose.

Please read all packaging and the Product Information Leaflet before taking any new medications. Inform your doctor about any medications you take or intend to take.

How to take Azithromycin tablets (antibiotics)

• Take one tablet a day for 3 days.
• Continue the course until it is complete unless a doctor directs otherwise.
• Start taking Azithromycin as soon symptoms of traveller’s diarrhoea occur. These include diarrhoea, sickness, nausea and stomach cramps.

How should I take Loperamide capsules (anti-diarrhoeals)?

• Take two capsules when diarrhea begins, followed by a further capsule after each loose bowel movement.

Do not take more than 8 capsules in 24 hours

Azithromycin 500mg

Inactive ingredients:

croscarmellose sodium (E468), magnesium stearate (E572), silicium dioxide (E551), microcrystalline cellulose (E460), poloxamer, povidone (E1201), talc waterfree lactose.

Coating:

hypromellose (E464), hydroxypropyl cellulose, macrogol, titanium dioxide (E171).

Side effects can include:

Mild allergic reactions (serious reactions are rare). If

You develop any of the following symptoms, contact your doctor immediately.

Sudden difficulty in speaking, breathing and swallowing

Swollen lips, face, tonue and neck

Extreme dizziness or fainting

Severe or itchy skin rash, especially if it includes blistering and the eyes, mouth or genital organs become sore.

Contact your doctor as soon as possible if you develop any of the following symptoms:

Diarrhoea that lasts a long time, is serious or has blood, accompanied by stomach pain or fever. This can signal a rare but serious bowel inflammation.

Yellowing of the whites of the eyes or skin as this can signal liver problems.

Severe pain in the abdomen and back which can indicate inflammation of the pancreas.

Reduced or increased urine output, or traces of blood in the urine

Skin rash caused by photosensitivity

Unusual bruises or bleeding

Irregular heart beat.

Other common side effects:

Diarrhoea

Abdominal pain

Nausea

Flatulence

Lack of appetite

Feeling dizzy

Headache

Tingly sensation or numbness

Changes in your sense of taste

Vision impairment

Deafness

Vomiting, stomach pain or cramps, digestion problems

Skin rashes and itching

Joint pain

Fatigue

Change in the concentration of bicarbonate in the blood and the quantity of the white blood cells.

If you are concerned about these effects, or if the product affects you in a different way, stop using Azithromycin and talk to your doctor or pharmacist.

• Record your other symptoms. Diarrhoea can be a symptom of other travel illnesses such as malaria or hepatitis. It is important to see a doctor if you do not improve within 3 days or have other severe symptoms such as headache or fever.
• Be cautious with water, ice, fruit, salads and seafood. These are usually the main culprits with traveller’s diarrhoea. Try to stick to bottled water and avoid fruits that cannot be peeled. Avoid drinks with ice and salads that may have been washed in water that is not fit for drinking.